Will hives go away untreated

How long can hives last?

Hives can appear and disappear quickly, with each hive only lasting around 23 hours. However, depending on the cause, they may reappear and continue affecting someone for days, weeks, or longer.

People can have acute hives, which occurs due to a specific trigger and resolves within 6 weeks. Alternatively, they can have chronic hives, which recur at least twice per week for longer than 6 weeks.

This article looks at how long hives last, factors that influence their duration, and treatment.

Each hive lasts only 23 hours, but for some people, they continue to appear and disappear for longer. The duration of hives can depend on whether they are acute or chronic.

Acute hives appear quickly and do not last long. Doctors classify hives as acute if the overall duration is less than 6 weeks.

However, around 25% of people go on to develop chronic hives. This is when hives regularly reappear over 6 weeks or more.

For many individuals, chronic hives eventually clear on their own, but this can take months. According to the American Academy of Dermatology Association (AAD), around half of people with chronic hives spontaneously recover within 1 year.

Acute hives often occur in response to an allergen or irritant. When the immune system perceives a substance as a threat, it releases histamine and other chemicals. This causes tiny blood vessels under someones skin to leak fluid, which accumulates and causes the bump.

Some common substances that can result in hives include:

• food allergens, such as milk, eggs, tree nuts, peanuts, or shellfish
• contact allergens, such as latex or animal dander
• insect bites or stings
• medications

Any drug can cause hives, but some of the medications most commonly associated with this symptom include:

Acute hives can also occur in response to viral infections, parasitic infections, or during times of stress.

According to a 2018 review, doctors are unsure of the cause of acute hives in around 50% of individuals. These cases are known as acute spontaneous urticaria (ASU).

Chronic hives may have the same cause as acute hives, but with symptoms lasting longer than 6 weeks. However, chronic hives are often not due to an allergen and instead have a physical cause.

There are two subcategories of chronic hives: inducible urticaria and chronic idiopathic urticaria.

Chronic idiopathic hives

Chronic idiopathic urticaria has no clear cause and is the most common form of chronic hives. Researchers are working to understand why this type of hives occurs, but a leading theory links it with autoimmunity.

Autoimmunity occurs when a persons immune system mistakenly attacks healthy tissue, and several autoimmune conditions are associated with chronic hives. The most common is thyroid disease, which is present in 9.8% of cases.

This suggests that the hives may result from someones immune system not functioning as it should. Other conditions that can occur alongside chronic hives include type 1 diabetes, lupus, and rheumatoid arthritis.

Infections can also be associated with the onset of chronic hives. This includes bacterial, viral, and parasitic infections. Again, this may result from autoimmunity an infection may trigger a change in how the persons immune system works.

Inducible hives

Inducible or physical urticaria is less common than chronic idiopathic urticaria. With this subtype, it is possible to purposely induce the hives by a person exposing their skin to certain triggers, which could include:

• Scratching or pressure: The most common type of inducible hives is known as dermatographia. This condition involves developing hives as a response to scratching or drawing on the skin.
• Cold: Cold hives occur on someones skin or mouth after exposure to cold temperatures. Triggers include consuming iced drinks, touching cold water, or going outside in cold weather.
• Heat: Cholinergic hives occurs when an individuals body becomes hot or sweaty. Hot baths, exercise, and spicy food can be triggers.
• UV light: Solar hives occur in response to UV light from the sun and certain light bulbs, such as those in tanning beds.
• Water: Some people develop hives if their skin comes into contact with water. This is known as aquagenic urticaria and is very rare.

Doctors diagnose hives by performing a physical examination. There is no test to determine whether the persons hives are acute or chronic, so they will use the length of time they recur to do this.

The doctor may also ask an individual:

• when the rash began
• the shape, size, and distribution of the rash
• where on the body they first noticed the rash
• if they have had any insect bites
• if they live or work with common hive triggers, such as chemicals, animals, or latex gloves
• if they have bone or joint pain, fever, or abdominal pain
• if anyone in their family experiences hives
• if they take any medications or supplements

The doctor may use a skin prick test and serum-specific IgE test to check if the acute hives result from a specific substance, such as food, dust mites, or chemicals. Alternatively, they may refer someone to an allergy clinic for these tests.

However, in cases of chronic hives, allergy testing is rarely useful. A doctor may check for other underlying health conditions by performing additional tests, such as:

The most suitable treatment depends on whether the person has acute hives or chronic hives.

Acute hives

Doctors typically recommend second-generation antihistamines as the first-line treatment for acute hives, such as:

• loratadine (Claritin)
• desloratadine (Clarinex)
• fexofenadine (Allegra)
• cetirizine (Zyrtec)
• levocetirizine (Xyzal)

They may prescribe a standard dose or increase by up to 4 times if the individual does not respond.

If these medications do not improve symptoms, the doctor may recommend an additional antihistamine, such as cimetidine (Tagamet), famotidine (Pepcid), or ranitidine (Zantac). They may recommend a 310-day course of corticosteroids to help control the symptoms in severe cases.

The doctor may prescribe an epinephrine auto-injector if they think the individual is at risk of anaphylaxis, which is a severe allergic reaction that restricts breathing. This provides emergency medicine to treat anaphylaxis quickly.

The doctor will then reassess the individual in 26 weeks.

Chronic hives

Doctors may recommend a four-step treatment plan for chronic hives. This approach involves using an antihistamine daily, which may be up to 4 times the regular dosage depending on how the individual responds.If necessary, they may prescribe a second antihistamine or another medication, such as montelukast (Singulair). With persistent hives, they may suggest a high potency antihistamine, such as hydroxyzine or doxepin.

The final step is for a doctor to refer the individual to a specialist for immunomodulatory therapy. This may involve taking medications such as omalizumab (Xolair) or cyclosporine (Sandimmune).

Once symptoms are under control, a doctor may gradually reduce the dosage of these medications. If the hives have an identifiable cause, such as cold or heat exposure, adopting changes to avoid the triggers wherever possible is also important.

The AAD suggests the following methods for people to reduce irritation and itchiness in hives:

• applying topical anti-itch medications, such as calamine lotion
• wearing loose-fitting clothing
• moisturizing with fragrance-free lotion to prevent dry skin
• using cold compresses several times per day

However, it is important for individuals to try to determine whether the hives have a specific trigger, in addition to relieving symptoms. If someone has cold hives, for example, a cold compress may make them worse.

Therefore, it is a good idea for people to keep a symptom diary, recording when the hives occur and any factors that might have contributed. Symptom diaries are also useful to refer to at medical appointments. A person can take note of:

• the date and time the hives appear
• what they were doing just before they developed
• what they have had to eat or drink

If any common factors emerge when the hives occur, a person can try to temporarily avoid these to see if it helps. It is important for people to do this with the guidance of a doctor, allergist, or dietitian if someone has food-related hives.

Learn more about remedies and treatments for hives here.

Hives do not last long, taking only 23 hours to fade. However, more can appear, which makes the symptoms last longer. Acute hives can develop and resolve on their own within 6 weeks, while chronic hives can last much longer.

Doctors treat acute and chronic hives differently, so it is advisable for people to speak with a medical professional about this symptom, especially if the hives last longer than 6 weeks.

If hives or swelling occur in the mouth and airways, making it difficult to breathe, dial 911 or the number of the nearest emergency department immediately.

Hives: Pictures, Causes, and How to Treat Them

Hives typically occur as an allergic response to something in your environment or something you ate. But they may sometimes happen because of an underlying health issue.

Hives, also known as urticaria, are itchy, raised welts that are found on the skin. Theyre usually red, pink, or flesh colored on lighter skin and may be flesh colored or slightly lighter or darker than your skin tone on brown or black skin.

Sometimes they sting or hurt. In most cases, hives are caused by an allergic reaction to a medication or food or are a reaction to an irritant in the environment.

In many cases, hives are an acute (temporary) problem that may be alleviated with allergy medications. Most rashes go away on their own. However, chronic (ongoing) cases, as well as hives accompanied by a severe allergic reaction, are larger medical concerns.

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Hives are usually caused by an allergic reaction to something that you have encountered or swallowed. When you have an allergic reaction, your body begins to release histamines into your blood. Histamines are chemicals your body produces in an attempt to defend itself against infection and other outside intruders.

In some people, histamines can cause swelling, itching, and many of the symptoms that are experienced with hives. In terms of allergens, hives can be caused by factors such as pollen, medications, food, animal dander, and insect bites.

Hives might also be caused by circumstances besides allergies. Its not uncommon for people to experience hives as the result of stress, tight clothes, exercise, illnesses, or infections.

Its also possible to develop hives as the result of excessive exposure to hot or cold temperatures or from irritation due to excessive sweating. Because there are several potential triggers, many times the actual cause of hives cant be determined.

People who are known to have allergies are more likely to get hives. You may also be at risk of developing hives if youre taking medication or if youre unknowingly exposed to things you may be allergic to, such as food or pollen. If youre already ill with an infection or a health condition, you may be more vulnerable to developing hives.

The most noticeable symptom of hives is the welts that appear on the skin. Welts may be red but can also be the same color as your skin. They can be small and round, ring-shaped, or large and of random shape. Hives are itchy, and they tend to appear in batches on the affected part of the body. They can grow larger, change shape, and spread.

Hives may disappear or reappear over the course of the outbreak. Individual hives welts can last anywhere from half an hour to a day. Hives may turn white when pressed. Sometimes the hives may change shape or form together and create a larger, raised area.

Hives can occur in a variety of places on the body. Call 911 or get medical attention immediately if you develop a hives outbreak around your throat or on your tongue or have trouble breathing along with hives.

Hives can occur in response to an allergic reaction or may not have an identifiable cause.

Allergic reactions

The most common causes of hives are allergic reactions. These can be caused by any allergen you might be sensitive to, including:

• foods (such as nuts, milk, and eggs)
• pet dander
• pollen
• dust mites
• insect bites or stings
• medications (primarily antibiotics, cancer drugs, or ibuprofen)

Mild cases of hives caused by allergies are typically treated with long- or short-term allergy medications and avoidance of the trigger.

Anaphylaxis

Anaphylaxis is a severe, life threatening allergic reaction. In this condition, hives are often accompanied by breathing difficulties, nausea or vomiting, severe swelling, and dizziness. Call 911 or your local emergency services immediately if you suspect youre experiencing anaphylaxis.

Chronic hives

Chronic hives are ongoing cases that dont necessarily have an identifiable cause. Also called chronic urticaria, this condition is marked by recurring hives that can interfere with your daily life. Chronic cases can last between weeks to several months or years.

You may suspect chronic hives if you have welts that dont go away within 6 weeks. While not life threatening, this form of hives can be uncomfortable and difficult to treat. Chronic hives may also be a symptom of an underlying health problem, such as:

• an autoimmune disorder
• celiac disease
• lupus
• type 1 diabetes
• rheumatoid arthritis
• thyroid disease

Dermatographism

This form of acute hives is considered mild. Excessive scratching or continuous pressure on the skin causes it. Dermatographism usually clears up on its own in a short period of time without treatment.

Temperature-induced hives

Sometimes changes in temperature can induce hives in people who are sensitive to such changes. Cold-induced hives may occur from cold water or air exposure, while body heat from physical activity may cause exercise-induced hives. Exposure to sunlight or tanning beds may also bring about solar hives in some people.

Infection-induced hives

Both viral and bacterial infections can cause hives. Common bacterial infections causing hives include urinary tract infections and strep throat. Viruses that cause infectious mononucleosis (mono), hepatitis, and colds often cause hives.

The first step in getting treatment is to figure out if you actually have hives. In most cases, a doctor will be able to determine if you have hives from a physical exam. Your skin will show signs of the welts that are linked with hives.

A doctor may also perform blood tests or skin tests to find out what may have caused your hives especially if your hives were the result of an allergic reaction.

You may not need prescription treatment if youre experiencing a mild case of hives not related to allergies or other health conditions. In these circumstances, a doctor might suggest that you find temporary relief by:

Anaphylaxis is a medical emergency that needs to be treated immediately by a physician. If you think you may be experiencing anaphylaxis, contact 911 or your local emergency services.

Simple changes to your lifestyle may be able to help you prevent hives from reoccurring in the future. If you have allergies and you know which substances are likely to cause an allergic reaction, a doctor will suggest that you avoid any possible exposure to these factors. Allergy shots are another option that may help you reduce the risk of experiencing hives again.

Avoid being in high humidity areas or wearing tight clothing if you have recently had a hives outbreak.

Below are some of the most commonly asked questions about hives.

Are hives contagious?

No, hives are not contagious and cant spread from one person to another.

Do hives mean Im allergic to something?

In many cases, hives are the result of an allergic reaction to something you have been exposed to, such as certain medications or pollen. It could also be caused by an infection, stress, or wearing clothes that are too tight. If you have hives that persist for more than a few days, contact a doctor to see if an allergy test is needed to determine the cause of your symptoms.

How long do hives last?

A hives outbreak can last anywhere from several hours to up to a week or two. If the hives are the result of an allergic reaction, they may last longer and require medical treatment. In some cases, chronic hives can last for months or even years. Talk with a doctor if you experience hives that dont go away on their own.

Are there any home remedies for hives?

Yes, there are several home remedies that may help alleviate the symptoms of hives. Taking an antihistamine is one option, as well as taking a cool or lukewarm bath with colloidal oatmeal or baking soda. Avoid hot water, as this may aggravate the hives. Also, try to avoid any potential irritants or allergens that may have caused the hives in the first place.

Although hives can be itchy and uncomfortable, usually theyre not severe and will disappear after a period of time. However, be aware that as some hives go away, new ones may pop up.

Mild cases of hives are considered harmless. Hives can be dangerous if you are having a serious allergic reaction and your throat is swelling. Prompt treatment for a severe case of hives is important for a good outlook.